Numerous therapeutic strategies to modify this response have arisen and include early excision and grafting
, thermoregulation, early continuous enteral feeding (high carbohydrate/high protein), the use of anabolic agents, growth hormone, IGF-1, IGFBP-3, insulin, oxandrolone, propranolol and the use of therapeutic exercise.
Other scar types may require lifting procedures such as subcision, fillers, and punch elevation, or excisional techniques such as punch excision and grafting
and elliptical and en bloc excisions.
Of these, more than half required excision and grafting
2 patients were treated with burn wound excision and grafting
but demised from sepsis on day 17 and 20.
Early excision and grafting is best done within the first week in full-thickness and deep dermal burns in a stable patient.
Early excision and grafting results in increased survival, decreased infection rates and decreased hospital stay.
While the superficial burns usually heal spontaneously within 3 weeks, the deeper burns require surgical excision and grafting.
Early excision and grafting has led to improved mortality rates, reduced pain and infective complications, reduced number of operative procedures, amelioration of the hypermetabolic response, decreasing incidence and severity of hypertrophic scarring, joint contractures and stiffness, excellent rehabilitation and shorter hospital stay.